Prairie Lakes Hospital Where Nurses Are Responsible for “The Whole Patient”

This improvement story originally appeared in IHI's 2006 Progress report.
There are some things all patients want — respect, information, compassion — but cultural and regional distinctions must also define patient-centeredness.
At Prairie Lakes Hospital in Watertown, South Dakota, part of the Transforming Care at the Bedside initiative and a member of IHI’s IMPACT network, staff members keep on top of patients’ needs without being on top of patients. “Our patients are Midwesterners,” says Shelly Turbak, RN, Director of Medical and Surgical Services. “They don’t want a crowd of people in their room. They just want to get better and go home.” So when staff members hold their daily interdisciplinary care conference, they don’t troop the care team into patient rooms.
But the patient is still the focus when representatives from physical therapy, social work, home health, and pastoral care meet. Led by the bedside nurse, the group reviews the patient’s status, and plans for a smooth transition home. “Nurses are traditionally very task oriented, focused on the plan for the day,” says Jill Fuller, RN, PhD, Chief Nursing Officer. “We are taking advantage of their critical thinking skills by giving them more responsibility for the whole patient and the whole stay, from admission to post-discharge.”
The approach pays off in several ways. “Our patients say they feel prepared when they leave, our readmission rates are very low, and our nurses are empowered to use all their skills,” says Fuller. 
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